Risk factors for high levels of prescription drug misuse and illicit drug use among substance-using young men who have sex with men (YMSM)

• Childhood physical abuse and stress are associated with high opioid misuse in young men who have sex with men (YMSM).
• High levels of perceived stress are associated with high tranquilizer misuse.
• Experiences of social discrimination and higher mental health distress are associated with high stimulant misuse.
• Prevention efforts must address risk behaviors in sync with psychosocial stressors.

BackgroundLimited research has focused on prescription drug misuse among young men who have sex with men (YMSM), or investigated risk factors contributing to misuse. This study aims to investigate the relationship between multiple psychosocial risk factors (i.e., childhood abuse, discrimination, mental health distress) and prescription drug misuse among YMSM who are current substance users.MethodsYMSM (N = 191) who reported prescription drug misuse in the past 6 months were recruited in Philadelphia between 2012 and 2013 to complete an anonymous survey assessing demographic information, substance use, and psychosocial factors.ResultsHigh levels of childhood physical abuse and perceived stress were associated with higher opioid misuse, while high levels of depression were associated with lower misuse of opioids. Those with higher levels of perceived stress were more likely to report higher tranquilizer misuse, while those with more experiences of social homophobia/racism and higher levels of depression and somatization reported higher stimulant misuse. Regarding demographic correlates, older participants were more likely than younger participants to report higher opioid misuse, while racial minorities were less likely than White participants to report higher misuse of tranquilizers, stimulants, and illicit drug use. Bisexual/heterosexual/other identified participants were more likely than gay identified participants to report higher misuse of all three classes of prescription drugs.ConclusionsAssociations of risk factors with substance use among YMSM are complex and offer opportunities for additional research. Our findings show that prevention efforts must address substance use among YMSM in sync with psychosocial stressors.